| NPI | 1689711178 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401006046)  | 
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MI 6301009757)  | 
| Enumeration Date | 2007-01-31 | 
| Last Update Date | 2016-01-22 |